Overview: Uterine wall perforation is a type of injury that occurs when something punctures or perforates the wall of the uterus; it often arises as a complication from an intrauterine procedure, such as the insertion of an intrauterine device (IUD). If not diagnosed and treated promptly, perforation of the uterine wall can lead to potentially fatal conditions such as sepsis or hemorrhage.
Women who have been implanted with an intrauterine device (IUD) such as the Mirena are at an increased risk of uterine wall perforation. Mirena IUD is a T-shaped device that can be left inside the uterus for up to five years in order to prevent pregnancy. If perforation does occur, it almost always happens when the IUD is inserted. Bayer, the manufacturer of Mirena IUD, states on its website that “Mirena may go through (perforate) the uterine wall. If your uterus is perforated, Mirena may no longer prevent pregnancy. It may move outside the uterus and can cause scarring, infection or damage to other organs. Surgery may be needed to have Mirena removed.”
Another risk factor is cervical stenosis, which means that the opening of the cervix is narrower than it should be, increasing the risk of uterine perforation during gynecologic procedures. Conditions that weaken the uterine wall, such as pregnancy or menopause, may also make women more susceptible to uterine perforation.
For women who have an IUD, symptoms may include pain and bleeding. However, some patients do not exhibit any symptoms. Uterine wall perforation is also suspected among IUD users when the strings are no longer visible.
Women who think they have a uterine wall perforation should see their doctor right away. Those who use an IUD and experience a perforation are no longer protected against pregnancy. If an IUD patient does conceive while the device is still implanted, there is a higher chance that it will result in an ectopic pregnancy.